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How Does Diabetes Affect Your Fertility And Pregnancy?

How Does Diabetes Affect Your Fertility And Pregnancy?

What Is Diabetes?

The human body uses glucose for energy. To do this it produces the hormone insulin which turns the glucose from the food we eat into energy. For those suffering with diabetes, the insulin supply is not adequate and the body struggles to convert enough glucose, leading to high levels of sugar in the body.

Types Of Diabetes

There are two main types of diabetes:

Type 1 Diabetes

This form of diabetes is, in fact, an autoimmune disease in which the immune system attacks cells responsible for creating insulin. Type 1 diabetes sufferers are insulin dependent and have to inject themselves to counteract the damage. This type of diabetes often presents in childhood, is not usually associated with weight issues. It cannot be controlled other than with insulin injections.

Type 2 Diabetes

With type 2 diabetes, the body loses its ability to produce correct insulin levels. This is known as insulin resistance. This is usually an onset disease and presents mostly after the age of 30. It is associated with obesity as extra weight makes the human body less sensitive to insulin production. If unchecked this type of diabetes can also destroy the cells which produce insulin, causing type 1 diabetes. It can be controlled by medicine, but it is essential to adapt your diet and lifestyle to see improvement.

These are common traits of both types of diabetes, but there are no hard and fast rules. You could be overweight and suffering with type 1 or of healthy weight and diagnosed with type 2.

The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.1

In the UK alone there are almost 3.6 million people diagnosed with the disease with numbers of young people diagnosed rising steadily.2

Diabetes And Obesity

Fat cells create an inflammatory response and can make the body less sensitive to insulin. Abdominal fat, in particular, is connected with the onset of type 2 diabetes. It’s important to note – if you are overweight or have an unhealthy lifestyle you are up to 80 times more likely to develop the disease.

What we know:

  • The UK has the highest levels of obesity in Europe
  • 1 in 4 adults are obese
  • Nearly 2/3 of adults are overweight
  • Nearly a third of all children are obese3

Diabetes And Fertility

It’s extremely important to find out whether you have diabetes before trying to conceive. If you have been trying for some time, it might be worth having a test to establish your glucose levels. Many diabetic women have healthy pregnancies and babies, but the disease has to be managed properly in order to minimise the many risks associated with trying for a baby from high glucose levels.

High glucose levels have an immediate impact on all hormones produced by the body, so the connection between diabetes and fertility issues is firmly established. The reproductive system is finely tuned hormonally, so any imbalances can impact heavily. There are many ways diabetes and high glucose affect the human body which can make both getting pregnant and carrying a baby to term difficult.

  1. Menstrual abnormality – conditions such as oligomenorrhea (infrequent periods) and secondary amenorrhea (when a woman with a normal cycle stops menstruating) are connected to diabetes. Of course without a regular and dependable cycle, conception will be more difficult.4
  2. Girls/women with diabetes tend to start periods later and enter the menopause sooner, thereby having less of a fertile window.
  3. Polycystic Ovary Syndrome – occurs when the female hormone system is out of balance, leading to the growth of cysts around the ovaries. A study by the University of Cardiff showed that women with PCOS were three times more likely to develop type 2 diabetes.5 Higher levels of glucose in the body can cause ovaries to produce too much testosterone, disturbing normal ovulation patterns.
  4. Autoimmunity – autoimmune diseases are well known contributors to infertility. Sometimes autoimmune diseases can occur hand in hand with both type 1 and type 2 diabetes.6
  5. Sexual dysfunction – between 35%-75% of men will experience erectile dysfunction due to diabetes.7

Not only can diabetes cause issues before trying to conceive, it can also wreak havoc with continuing a pregnancy. A pregnant woman is 30-60% more likely to miscarry if she has high glucose levels according to the American Diabetes Association.

Diabetes can also cause difficulties when you are carrying a baby.

If you have been trying for a baby without success, book in with a Private Fertility Consultant or IVF/Fertility Clinic for peace of mind.

Gestational Diabetes

Hormonal changes during pregnancy will naturally affect the way your body is able to deal with glucose, but for some (particularly those with existing weight issues/bad diets/pre-existing related conditions), diabetes can appear during pregnancy (most likely in the second term).

You are at risk from gestational diabetes if:

  • Your BMI is above 30
  • You’ve had a large baby previously (over 10lbs)
  • A parent or sibling has had diabetes
  • You are of Asian, Chinese, Afro American or Middle Eastern descent8

Diabetes during pregnancy can increase the risk of:

  • Bigger babies – leading to birth risks, caesareans and assisted births
  • Polyhydramnios – having too much amniotic fluid which can cause premature labour
  • Birth defects
  • Stillbirth
  • Premature delivery

Diabetes And Men’s Fertility

Diabetes has as much of an effect on a man’s fertility as a woman’s.

Tests showed DNA in sperm from diabetic men had more signs of damage than in men without the condition.9

Defective sperm is found more frequently in men with diabetes than those without. This was true for both type 1 and type 2 diabetes sufferers. Again high levels of glucose seem to be the root cause of reduced quality sperm.

There are other ways that diabetes can have a negative impact on male fertility:

  1. Erectile dysfunction – uncontrolled diabetes can cause damage to nerve endings which in turn has an effect on a man’s ability to get or maintain an erection.
  2. Retarded ejaculation – as with the above, decreased nerve sensitivity can have a negative effect on ejaculation.
  3. Retrograde ejaculation – occurs when the sperm is redirected to the bladder instead of out via the urethra.
  4. Low testosterone – “NHS Diabetes reports that 16% of males with type 2 diabetes have lower than normal levels of testosterone”.10

Fortunately, many of these issues can be treated with IVF procedures, such as surgical sperm aspiration. But again, it is better if you make good lifestyle choices to maintain a healthy body.

So What Can Be Done?

Yes, it all sounds a bit doom and gloom! And, yes, there are many risks associated with diabetes and its effect on fertility and carrying a baby to term. However, many women with the disease have babies without issue but it takes a lot of research, advice and planning to ensure that the risks are minimised.

  1. Treatment before conception. If you have any underlying issues such as a weight problem, high blood pressure, eye or kidney disease – make sure that these are treated prior to trying for a baby. It is advisable that you are in good physical health before having a baby as the physical toll of pregnancy can make conditions worse.
  2. Leading a healthy lifestyle. Many lifestyle factors have a negative effect on the body’s functioning systems. Tobacco, alcohol, drugs and bad diet will put every part of your body, including your reproductive system under strain. Make sure you are at a suitable weight, that you take regular exercise and that your food intake is made up of healthy nutritious food sources. Lean protein, pulses, complex carbs such as grains, fruit and vegetables. Steer clear of stodgy food and empty calories. Avoid excessive caffeine, carbonated fizzy drinks, sugar, refined foods, low fat foods, too many animal fats (trans fats) and proteins (try plant proteins instead). If you are overweight or obese, chances are your glucose levels are too high and you are at risk of developing diabetes.
  3. Medications – some medications cannot be used during pregnancy. Insulin is the safest way of regulating blood sugar levels when pregnant. Switching your medication programme is advisable prior to conception.
  4. Keep track of your blood sugar levels – poor blood sugar levels can have an effect on baby development even before you’re know you’re pregnant. Your risk of birth defects and miscarriage will be increased if you have poor blood sugar levels, even in the first few weeks of pregnancy.
  5. Consult your health provider. They will be able to advise you on what levels you should be keeping. It’s advisable to get to the correct levels in the months preceding trying for a baby, so that you have become accustomed to the new medications/routine and that your body is settled and as healthy as possible.

So whilst there are many risks when trying for a baby and carrying a baby with diabetes, the most important thing you can do is make sensible adjustments and plan well in advance. The healthier you are, the better your body will respond to trying for and carrying a baby. Seeing your doctor, doing your research and having a well thought out plan in the months before trying for a baby will ensure better results. And if you’ve been trying for some time to get pregnant, it’s worth thinking about a well woman check just to make sure that your health is good. It could be high glucose levels that are preventing you from getting pregnant in the first place.

knowyourrisk-poster-Diabetesweek

REFERENCES

[1] http://www.who.int/mediacentre/factsheets/fs312/en/
[2] https://www.diabetes.org.uk/Professionals/Position-statements-reports/Statistics/Diabetes-prevalence-2016/
[3] http://www.diabetes.co.uk/diabetes-and-obesity.html
[4] https://www.ncbi.nlm.nih.gov/pubmed/19863473
[5] http://www.diabetes.co.uk/news/2012/Mar/polycystic-ovary-syndrome-can-raise-diabetes-risk-threefold-97794970.html
[6] http://journals.sagepub.com/doi/pdf/10.2217/WHE.09.47
[7] http://journals.sagepub.com/doi/pdf/10.2217/WHE.09.47
[8] http://www.nhs.uk/conditions/gestational-diabetes/Pages/Introduction.aspx
[9] http://news.bbc.co.uk/1/hi/health/6615261.stm
[10] http://www.diabetes.co.uk/low-testosterone-and-diabetes.html

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